Form F-30 - Alcoholics Anonymous New Group Form
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1A
A
N
G
F
LCOHOLICS
NONYMOUS
EW
ROUP
ORM
U.S. and Canada
“Our membership ought to include all who suffer from alcoholism. Hence we may refuse none who wish to recover. Nor ought A.A. Membership ever depend
upon money or conformity. Any two or three alcoholics gathered together for sobriety may call themselves an A.A. group, provided that, as a group they have
no other affiliation.” — Tradition Three (the long form)
“Each Alcoholics Anonymous group ought to be a spiritual entity having but one primary purpose — that of carrying its message to the alcoholic who still suffers.”
— Tradition Five (the long form)
“Unless there is approximate conformity to A.A.’s Twelve Traditions, the group... can deteriorate and die.” — Twelve Steps and Twelve Traditions, page 174.
A.A.’s Traditions suggest that a group not be named after a facility or member (living or deceased), and that the name of a group
not imply affiliation with any sect, religion, organization or institution.
GROUP NAME: _________________________________________________________________
GROUP START DATE: _____________________
GROUP MEETING LOCATION: ___________________________________________________
NUMBER OF MEMBERS: ____________________
ADDRESS: _______________________________________________________________________________________________________________________________
CITY/TOW N: ______________________________________________
STATE/PROVINCE: __________________________ ZIP CODE: ______________
MEETING DAY
MON
TUES
W ED
THURS
FRI
SAT
SUN
MEETING TIMES
____________
____________
____________
____________
____________
____________
___________
LANGUAGE (Please check one
)
ENGLISH
SPANISH
FRENCH
OTHER ________________________
(Specify )
GENERAL SERVICE REPRESENTATIVE
NAME: ____________________________________________________________
E-MAIL: ________________________________________________
ADDRESS: _________________________________________________________
CITY/ TOW N: _________________________________________
STATE/PROVINCE: _______________________________________
ZIP CODE: ____________________
TELEPHONE: _________________________
ALTERNATE G.S.R.
OR MAIL CONTACT
( Please check one
)
NAME: ____________________________________________________________
E-MAIL: ________________________________________________
ADDRESS: _________________________________________________________
CITY/ TOW N: _________________________________________
STATE/PROVINCE: _______________________________________
ZIP CODE: ____________________
TELEPHONE: _________________________
Does y our Group meet in a hospital, treatment center or detox center?
Yes
No
If y es, is it open to A.A. members in the community as w ell as to patients in the center?
Yes
No
If the Group is to be listed in the Directory, please provide a telephone number and mailing address for the G.S.R., Alternate
G.S.R., or Group contact. Listing in the Directory is for Tw elfth Step referral and/or for meeting information. The G.S.R.’s (or other
contact) name and telephone number w ill be included in the Directory w ith the group’s name and service number.
OK TO LIST IN THE DIRECTORY?
Yes
No
SIGNATURE: _________________________________________________________________
DATE: ______________________
THREE WAYS TO RETURN THIS FORM G.S.O:
Postal Mail to: A.A. World Services, Inc.
By Fax : 212-870-3003 (Attn: Records)
E-mail: records@
Grand Central Station
P.O. Box 459
New York, NY 10163
Once complete information is entered into the database by GSO or by the Area Registrar your group will be subject to a 30 day pending
period. Once the pending period expires a “New Group Handbook” will be mailed and should arrive within 7-14 business days. Handbook
contents are available on the “Group Life” page at .
FOR G.S.O. RECORDS DEPT. USE ONLY
DELEGATE AREA NUMBER: _______________________
DISTRICT NUMBER:_______________________
GROUP SERVICE NUMBER (ASSIGN BY G.S.O.) _______________________
F-30 -
Revised 8 -16
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